• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Code By Payer Specifics

dmjbear

Contributor
Messages
14
Best answers
0
Does your practice or health care facility code your professional services (physician services, not hospital) for all services even if the payer bundles the CPT/HCPC or do you code per payer guideline specifics/bundling?

Examples:

1) Blue Cross Blue Shield bundles the G0101 and Q0091 with a preventative exam 99381-99387, would you code the G0101 and Q0091 on the claim or not code it due to the bundling edit? Or do you code it and make adjustments on the billing side?

2) When a patient is seen and has a split bill (preventative/sick visit) Blue Cross Blue Shield does not allow both codes, would you code both or would you remove the CPT that has the least medical necessity for the visit documentation.
 
Top